On Fitness
By Richard Seven
Know The Drill
A training regimen can help keep kids from being brought to their knees
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 JIM BATES / THE SEATTLE TIMES Stephanie Wangle, a junior at Inglemoor High School who is recovering from knee surgery, is working with physical therapist John Rumpeltes to try to get back on her school's soccer team. Part of her rehab is using stretch bands for sumo squats and other neuromuscular-training exercises.
THE LOS ANGELES TIMES The Vulnerable ACL
One of the most common knee injuries involves damage to the anterior cruciate ligament (ACL). ACL injuries are most common in soccer, basketball, volleyball and other sports that require rapid movement, jumping and quick changes in direction. |
EACH YEAR, about one in 3,000 people tears an anterior cruciate ligament (ACL), which is designed to stabilize the knee. That rate is far higher in young athletes, particularly girls.
In fact, research has found that women and girls suffer the injury at a frequency of up to six times greater than male athletes do. The gender disparity seems to begin at about 12 years old, when girls typically enter a growth spurt. The risk appears to peak at 16, but continues into maturity. One explanation is that as the pelvis widens it changes the angle to the knees. That structural alteration can influence injury, some experts surmise, if the athlete does not recruit proper muscles and use good form while cutting, pivoting and making other sharp movements. Another thought is that kids are not adequately being conditioned and trained to move correctly.
This disturbing trend has prompted considerable study among medical and rehabilitative professionals and renewed attention on preparing young athletes to move in more functional ways. Proper neuromuscular training — teaching your body parts to work in sync — can make a profound difference in preventing injuries like ACL tears, studies suggest.
ACL injuries typically occur when the athlete either decelerates before changing direction or lands from a jump while the leg is close to being fully extended. Weekend warriors should pay attention, too, because most ACL injuries are "noncontact" injuries.
A few years ago, a group of California physicians, physical therapists, athletic trainers and coaches created The Santa Monica ACL Prevention Project, which promotes prevention and education through a series of specific exercises for young athletes.
Try the lateral hop, courtesy of Athletic Engineering:
Standing on one leg, jump laterally and land on the other leg. Land softly and bend the knee and hip when you land. Do not land with a straight leg. This can be done at any pace, but work on control and shorter jumps before stretching out the movement.
You can add to this movement by touching a cone or other object with the hand opposite the landing foot. The reaching motion mimics skating.
The sport-specific drills address strength and coordination of the stabilizing muscles around the knee joint and help athletes avoid vulnerable positions. The drills should be done two to three times a week, and proper technique is a must. The drills are also designed to increase body awareness. The Amateur Athletic Foundation collaborated with the Santa Monica program to offer video illustrations of more than a dozen preventive exercises. Go to http://www.aafla.org and click on "coaching education." From there, click on a link to "ACL injury reduction."
Neuromuscular training, through repetition, teaches how to coordinate the various forces your body goes through in a movement and how to recruit the right timing, frequency and force of those muscles.
John Rumpeltes is managing partner of Olympic Physical Therapy and co-founder of Seattle's Athletic Engineering, a division of the business, which leads structured functional training for rehabbing clients and athletes.
Athletic Engineering, headed by Tim Nausin, has worked with Seattle University and Seattle Pacific Soccer teams for years and partnered with the Seattle Storm on an injury-prevention workshop last year. Now the men are looking for ways to implement an ongoing community program based on the Santa Monica model. They seek more emphasis on injury prevention in youth sports.
"We see a lot of ACL injuries," says Rumpeltes. "You read literature and see it in epidemic proportions around the country. If we are going to change the culture on how we are training our kids and athletes, we have to make it time-efficient, perhaps a 10-minute warm-up program that includes neuromuscular training."
The training includes simple things, like learning the right way to squat by balancing the stress between hip, knee and ankle to more complex moves like reaching in various directions while standing on one leg. Rumpeltes says serious athletes have one thing in common: well-developed hips and core muscles that help decelerate and control the movement farther down the body's chain. He wants to see coaches help kids strengthen their hips and core, too.
Richard Seven is a Pacific Northwest magazine staff writer. He can be reached at rseven@seattletimes.com. Jim Bates is a Seattle Times staff photographer.
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